S1E6 Traumatic Childbirth with Cali Buckheit, MD

One of the defining moments in my health was the birth of my son in 2019. Like many moms who experienced traumatic childbirth, I grieved (and still grieve) the loss of the birth and pregnancy I so desired. Instead, I felt:* guilt, grief, and anger that my body “let me down”* invalidated by comments like, “at least your baby is okay”* pressure to “bounce back” after birth despite the trauma I experienced.Can you relate?In this episode I ask OBGyn Dr. Caledonia “Cali” Buckheit:* what constitutes birth trauma?* how to show up for loved ones who experience traumatic childbirth* how to think about “birth plans,” and when they go awry* what permission we might need to heal from birth traumaThis episode will resonate if you:* Have experienced childbirth that didn’t go as planned and had to navigate the emotional aftermath.* Want to support a friend or loved one who has gone through a traumatic birth experience.* Are an expectant parent seeking advice on how to approach birth plans.* Struggle with feelings of guilt, disappointment, or grief related to your birth experience.⚠️ Trigger warning: This episode contains descriptions of medical injury and illness.I did my first load of newborn laundry with joy and anticipation in January 2019.I was 29 weeks pregnant with my son, who did tumbling summersaults like the clothes in the dryer while I folded his tiny garments on my round belly.Like a lot of (first time) moms, I had a plan for how my son would come into the world. It involved mindful birthing, lavender essential oil, and a meticulously-curated playlist.He’d wear the softest grey onesie to come home from the hospital, which I folded and packed in the hospital “go bag” I’d grab on the way out the door in late March when I went into labor and my contractions were five minutes apart.You know what they say about the best-laid plans of mice and men (and moms), right?They go awry.I finished folding the laundry, put on the winter parka that no longer zipped over my pregnant self, and went out to shovel the driveway, where I slipped on ice and fell hard on the handle of the snow shovel.In triage at the hospital I was told my baby was okay, but, dear God, my blood pressure was high.Before I knew it I was hospitalized with preeclampsia for a month, then induced to have my son before my organs started failing. He was born six weeks early and spent his first weeks in the neonatal intensive care unit, or NICU.After a month confined to the labor-and-delivery unit, I clung to the remnants of my birth plan — the mindfulness, the lavender, and the playlist, and the no epidural — until my body started to fail, labor stalled, and we lost my son’s heartbeat.Duke- and Dartmouth-trained obstetrician-gynecologist Caledonia “Cali” Buckheit, MD doesn’t put a lot of stock in birth plans anymore. And not just because she’s seen her fair share of patients who, like me, crumbled under the disappointment and loss of control, but because her own birth plans failed, twice. And she barely survived the second.“I was gonna deliver, like, two weeks before I graduated from residency and then go off into the sunset on my maternity leave, and have some time off before starting my attending job.”“That's where listeria came in. I ended up delivering three months early.”Listen to the episode to hear Cali’s story.Now, Cali is in private practice where her special interests include minimally invasive surgery, menopause, and contraception. She regularly counsels patients and their partners through the biggest transitions and traumas of their lives.Modern Hysteria is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Q+A with Cali Buckheit, MDWhat is birth trauma, and what are common types you see in your practice?CB: “One piece of my birth trauma came from losing the outcome I expected for my pregnancy… It really felt like I had to grieve the loss of all of what I thought I was going to have in my pregnancy, in my birth, in my postpartum experience.”→ Trauma often arises when unexpected complications—like preeclampsia, gestational diabetes, or emergencies—cause fear and overwhelm.How can we think realistically about “birth plans?”CB: “More important than the specifics are: Who’s in your corner? Who are my providers? Who are the people I trust? What do I want? I want to feel safe. I want to feel like I understand what’s going on.”→ Focus on trust and safety rather than fixating on specifics like epidurals or delivery type.How do you recommend showing up for someone who has experienced birth trauma?CB: “You’re not going to make it okay… Instead, focus on being supportive, being kind, and providing meaningful support. Like my colleagues and friends showing up and taking care of my other child so my husband and I could go to the NICU together—huge.”“Ask more interesting questions instead of just saying, ‘Congratulations.’ Instead, ask, ‘What was good and what was bad about your delivery?’ Because it’s not usually one emotion. There are these beautiful moments, but also terrifying ones.”→ Practical actions, not empty reassurances, make the difference.What permissions do women need to start healing from birth trauma?CB: “A lot of self-love. Like, what I am and where I am is enough, even if none of this feels okay or feels good… I think as women, we feel like we should be able to do it all. But that’s not true. That’s something we’ve told ourselves, and it’s not true.”What role does social media or community play in healing from birth trauma?CB: “There’s a group called Preemiehood that talks about things you would only understand if you’d been in the NICU. It makes you feel not alone. It makes you feel seen.”What misconceptions about birth trauma should we challenge?“We have this desire to make everything okay. But it’s not okay. None of it is okay, but it’s happening. We’re going through it one step at a time. Let go of the idea that labor, delivery, and childbirth are supposed to be these beautiful, happy times.”Key moments in this episode* 8:18: The unexpected nature of traumatic childbirth* 10:48: Letting go of your birth plan* 26:43: The world of the NICU mom* 45:42: How to show up for someone who had a traumatic childbirth* 46:09: Why traumatic childbirth is so emotionally complex* 50:01: Why your friends and community are so healingConnect with Cali📲 Follow her on Instagram, Threads, and TikTok🏥 Are you in the Raleigh, NC area? Make an appointment with Dr. Cali Buckheit here.Thanks for reading and listening, friend.In the next episode of Modern Hysteria we’ll do a deep-dive on PMADs, or perinatal mood disorders like:* postpartum anxiety* postpartum depressionI’ll interview birth researcher and doula Kelsey Marr about why we develop postpartum mood disorders and how we can plan practically to heal and avoid them. This is a public episode. 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